Seth Stoller, M.D., Pain Management

Types of Pain

Everyone experiences pain at one point or another. It often is an indication that something is wrong. Each individual is the best judge of his or her own pain. Feelings of pain can range from mild and occasional to severe and constant.

What Is Acute Pain?

Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. Acute pain may be caused by many events or circumstances, including surgery, broken bones, dental work, burns or cuts, and labor and childbirth. Acute pain may be mild and last just a moment, or it may be severe and last for weeks or months. In most cases, acute pain does not last longer than six months and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, may lead to chronic pain.

What Is Chronic Pain?

Chronic pain persists despite the fact that an injury has healed. Pain signals remain active in the nervous system for weeks, months, or years. Physical effects include tense muscles, limited mobility, a lack of energy, and changes in appetite. Emotional effects include depression, anger, anxiety, and fear of re-injury. Such a fear may hinder a person's ability to return to normal work or leisure activities. Common chronic pain complaints include:

• Headache
• Low back pain
• Cancer pain
• Arthritis pain
• Neurogenic pain (pain resulting from damage to nerves)
• Psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside)

Chronic pain may have originated with an initial trauma/injury or infection, or there may be an ongoing cause of pain. However, some people suffer chronic pain in the absence of any past injury or evidence of body damage.

What Causes Pain?

Pain receptors, called nociceptors, send signals to your brain via your spinal column telling you of the danger, so you can take measures to protect yourself or prevent further injury. This type of pain, called nociceptive pain, is the most common. It is experienced with muscle or bone injuries, surgery, or pressure from an infection or condition like cancer. It can be experienced as sharp, dull or aching, in a large or small area, and generally goes away as the damage to your body heals.

This type of pain can last for months or years when damaged tissues cannot heal, or chronic inflammation is involved. Arthritis, some kinds of neck and back pain, osteoporosis pain, some kinds of cancer pain, and many other types of chronic pain are nociceptive.

Another type of pain is caused by injured nerves, or other changes in the nervous system, and is called neuropathic pain. The disturbed nervous system sends pain signals to the brain even when there is no other ongoing tissue damage. Neuropathic pain is often experienced as tingling, aching, or burning and can last for months or years.

Types of neuropathic pain include peripheral neuropathy, neuralgia, and complex regional pain syndrome (CRPS).

Some patients have chronic pain, and doctors cannot pinpoint the source. Often, it is best to refer to this pain as idiopathic -- which means that the cause is unknown.

All types of pain are subjective and can be measured and reported only by the person experiencing it. All types of pain are real and can be treated. Many factors influence the experience of pain, including the mechanisms in the body that are sustaining the pain, the meaning of the pain, and psychological factors, such as individual coping styles and emotional support.

How Is Pain Treated?

Depending upon its severity, pain may be treated in a number of ways. Symptomatic options for the treatment of pain may include one or more of the following:

• Drug treatments such as non-prescription medications like Aleve, Motrin and Tylenol or stronger medications such as morphine, codeine or anesthesia.
• Nerve blocks (the blocking of a group of nerves with local anesthetics)
• Alternative treatments such as acupuncture, relaxation and biofeedback
• Electrical stimulation
• Physical therapy
• Surgery
• Psychological counseling
• Behavior modification

Some pain medicines are more effective in fighting pain when they are combined with other methods of treatment. You may need to try various methods to maintain maximum pain relief.